Individual
SHANKAR AYYASWAMY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1801 N ARALIA DR, MOUNT PROSPECT, IL 60056-1632
(814) 618-1000
(847) 618-8939
Mailing address
1801 N ARALIA DR, MOUNT PROSPECT, IL 60056-1632
(814) 618-1000
(847) 618-8939
Taxonomy
Speciality
Code
Description
License number
State
163WG0000X
General Practice Registered Nurse
Primary
041398361
IL
Other
Enumeration date
07/21/2026
Last updated
07/21/2026
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